Employee retirement system baltimore city

• [PDF File]Declaration for Federal Employment* OMB No. 3206-0182

  https://info.5y1.org/employee-retirement-system-baltimore-city_1_34736d.html

  Declaration for Federal Employment* (*This form may also be used to assess fitness for federal contract employment) Form Approved: OMB No. 3206-0182 U.S. Office of Personnel Management. 5 U.S.C. 1302, 3301, 3304, 3328 & 8716

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• [PDF File]AUTHORIZATION, AGREEMENT B. Request Status …

  https://info.5y1.org/employee-retirement-system-baltimore-city_1_9ade80.html

  Social Security Number - Use employee's nine (9) digit SSN. (123-45-6789) OR Federal Employee Number -The unique number that Enterprise Human Resources Integration (EHRI) will assign to an employee to identify employee records within the EHRI system. (Agency)

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• [PDF File]Form N-648, Medical Certification for Disability Exceptions

  https://info.5y1.org/employee-retirement-system-baltimore-city_1_6515b8.html

  City State or Province. Zip Code or Postal Code Last Name. First Name Middle Name. Was a phone interpreter used? Yes (If "Yes", the interpreter is not required to complete the information below.) No (If "No", the interpreter is required to complete the information below.) Interpreter Signature.

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• [PDF File]Form SSA-89 (02-2018) Discontinue Previous Editions Page 1 ...

  https://info.5y1.org/employee-retirement-system-baltimore-city_1_ef6bef.html

  Form SSA-89 (02-2018) Discontinue Previous Editions Social Security Administration. Page 1 of 2 OMB No.0960-0760. Authorization for the Social Security Administration (SSA)

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• [DOC File]LEAVE REQUEST FORM/AUTHORIZATION - United States Navy

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  separation retirement other for use outus only 12. mode of travel. air bus. car train 11a. leaving area of permdusta. yes no 11b. taking leave inconus. yes no 13. days requested. 14. from (hour, date) (yymmdd) 15. to (hour, date) (yymmdd) 16. normal working hours. day of departure:

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• [PDF File]Form W-9 (Rev. October 2018)

  https://info.5y1.org/employee-retirement-system-baltimore-city_1_7ff93a.html

  City, state, and ZIP code. Requester’s name and address (optional) 7. List account number(s) here (optional) Part I Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid backup withholding. For individuals, this is generally your social security number (SSN).

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• [PDF File]Request for Social Security Earnings Information

  https://info.5y1.org/employee-retirement-system-baltimore-city_1_6555c9.html

  Form . SSA-7050-F4 (03-2019) Page 2 of 4. REQUEST FOR SOCIAL SECURITY EARNING INFORMATION . 1. Provide your name as it appears on your most recent Social Security card or the name of the individual whose

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• [PDF File]Application for MTA Reduced-Fare MetroCard for Senior ...

  https://info.5y1.org/employee-retirement-system-baltimore-city_1_5b85bb.html

  malfunction, or disabling of the RFM or the MetroCard system. The MTA Reduced-Fare MetroCard and its use are subject to all tariff provisions, rules and regulations of the New York City Transit Authority and its affiliates, and Westchester County Bee-Line System. For more information, call 718-330-1234 6 …

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• [DOC File]Aid Codes Master Chart (aid codes) - Medi-Cal

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  The chart includes only aid codes used to bill for services through the Medi-Cal claims processing system and for other non Medi-Cal programs that need to verify eligibility through AEVS. Note: Unless stated otherwise, these aid codes cover United States citizens, United States nationals and immigrants in a satisfactory immigration status.

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